Disagreements remain about acceptable delay for surgical repair of hip fracture. Guidelines in the U.S. and Canada recommend surgery within 48 hours.
‘Patients who undergo hip fracture surgery after 24 hours are at a risk of developing heart attack, deep vein thrombosis, pulmonary embolism and pneumonia.’
About 42,230 adults who had hip fracture surgery between April 2009 and March 2014 at 72 hospitals in Ontario, Canada.
Time in hours from emergency department arrival until surgery (exposure); death within 30 days of hospital admittance for hip fracture surgery (outcome).
This is an observational study. Because researchers are not intervening for purposes of the study they cannot control natural differences that could explain study findings.
In observational studies, researchers observe exposures and outcomes for patients as they occur naturally in clinical care or real life. Because researchers are not intervening for purposes of the study they cannot control natural differences that could explain study findings so they cannot prove a cause-and-effect relationship.
The authors were Daniel Pincus, M.D., of the University of Toronto, and his coauthors.
Patients who had surgery for hip fracture after 24 hours had an increased risk of death compared to patients who had surgery within 24 hours (6.5 percent vs 5.8 percent).
The risk of complications, such as heart attack, deep vein thrombosis, pulmonary embolism, and pneumonia, were also higher for patients who had surgery after 24 hours.
The limitation of the study is that sick patients who may have died awaiting surgery were not included in the study.